ISHLT Response to OPTN Improve Deceased Donor Evaluation for Endemic Diseases
Published 8 March 2023
The International Society for Heart and Lung Transplantation (ISHLT) appreciates the opportunity to provide feedback on the "Improve Deceased Donor Evaluation for Endemic Diseases” OPTN special public comment.
ISHLT generally supports the concept of universal screening to ensure that these preventable diseases do not impact post-transplant outcome. However, the proposal does not provide sufficient data to demonstrate that the benefit of having universally available serology will outweigh the risk of increased non-utilization of otherwise suitable organs or provide sufficient information about how the latter risk would be mitigated if the proposal is adopted. Specifically:
- The proposal fails to provide specific details about expected positivity rates for Strongyloides and failed to note that there are subpopulations of patients at higher risk of
Strongyloides than others. The proposal allows results to be provided after allocation but
does not establish a required time frame for results to be made available.
- The proposal does not provide adequate information about how transplant centers will be adequately educated to ensure that Strongyloides and Chagas results made available prior to allocation do not lead to increased non-utilization of organs.